The diagnosis – psychiatric assessment

Having a psychiatric assessment felt like I had failed in both my quest to prove I do not have mental health issues, and as a human.

Within the first couple of minutes he said he had a fair idea of what the problem was, the report sent to him by Heidi had given him a very clear history. He advised he would be asking me a lot of questions and I should tell him if it get to intrusive or too much.

I have to admit I was terrified, I prayed that my suspicions about having BPD (Do I have Borderline Personality Disorder?) would not be confirmed.

The assessment

Unlike the assessment with the psychologist, this one was more about me, what I think and feel. There were no questionnaires. The questions were intense, not subjects you would consider talking to a total stranger about. The questions were very much centred around the symptoms I had read about previously.

The diagnostic criteria can be found on the NHS website.

Internationally recognised criteria are used to diagnose BPD. A diagnosis can usually be made if you answer “yes” to 5 or more of the following questions:

  • Have an intense fear of being left alone, which causes you to act in ways that, on reflection, seem out of the ordinary or extreme, such as constantly phoning somebody
  • Do you have a pattern of intense and unstable relationships with other people that switch between thinking you love that person and they’re wonderful to hating that person and thinking they’re terrible?
  • Ever feel you do not have a strong sense of your own self and are unclear about your self-image?
  • You engage in impulsive activities in 2 areas that are potentially damaging, such as unsafe sex, drug misuse or reckless spending (but not including self-harming or suicidal behaviour)?
  • Have you made repeated suicide threats or attempts in your past and engaged in self-harming?
  • You have severe mood swings, such as feeling intensely depressed, anxious or irritable, which last from a few hours to a few days?
  • Do you have long-term feelings of emptiness and loneliness?
  • Do you have sudden and intense feelings of anger and aggression, and often find it difficult to control your anger?
  • When you find yourself in stressful situations, do you have feelings of paranoia, or do you feel like you’re disconnected from the world or from your own body, thoughts and behaviour?

The diagnosis

Apparently I do meet most of the criteria detailed above. I therefore have a confirmed diagnosis of BPD or Emotionally Unstable Personality Disorder (EUPD) as its also known. Not only do I have this condition, I have had it since my early teens (Depression sets in). I had it when I started self harming all those years ago. I had it when I was sectioned and kept in hospital in my early twenties. It was somehow missed by those who treated me.

I have compensated for it, used my resources to find ways round living with how I feel. He suggested that I have done very well to live with it for so long. It was also acknowledged how hard my life must have been at times. I was assured that my strength and determination was a positive and will help me in my recovery.

I was also diagnosed me with Post Traumatic Stress Disorder PTSD.

Treatment I need

He has written a report to my GP (my secret is no longer hidden), suggesting that I am a risk to myself and potentially others. Whilst I accept I am a risk to myself, I strongly disagree that I am a risk to others. I lock myself away during my turbulent times. He has suggested due to my complex presentation (whatever that may mean) I need to be referred to the local community mental health team.

He suggests that I will benefit from psychological treatment. For the BPD/EUPD either Dialectical Behavioural Therapy (DBT) Or Mentalization Based Therapy (MBT). For the PTSD either Trauma-Focused CBT or Eye Movement Desensitisation and Reprocessing (EMDR) therapy.

He also recommends medication to help stabilise my moods.

It is a lot for me to take in. I’d so hoped that I was wrong when I had suggested to Heidi that I had BPD. I cannot get my head around how I have lived with this for 30 years and had no idea. I mean I knew something was wrong…

Once I finally get my head around it, I can only hope it enable me to get the help and support I need to enable me to live a more “normal” life.

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